• Title/Summary/Keyword: Nasal surgery

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A Case of Orthognathic Surgery in Congenital Alveolar-Palatal cleft patient (구순 및 구개열을 가진 상악 후퇴증 환자의 교정-외과적 치험 1례)

  • Park, Jae-Hyun;Lee, Myung-Jin;Lee, Chang-Kon;Kim, Jong-Sub;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.189-196
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    • 1992
  • Pre-surgical and post-surgical change in adult cleft lip and palate patient following Le Fort I advancement osteotomy combined with bone graft was evaluated clinically and cephalometically. We obtained a successful function and esthetic improvement. The bone graft of alveolo-palatal clefts provides a stable bone support to the adjacent teeth of the cleft area, and well union of adjacent bone tissue, the closure of oronasal fistula and improvement of speech problem. Le Fort I osteotomy following the ostectomy of nasal septum for advancement of the maxilla was obtained relative improvement of esthetics and functional occlusion. 1. The orthodontic correction was required before and after surgery. 2. In this case, there was a limited range of anterior advancement of the Premaxillary-segment due to the scar tissue. 3. After 8 months of operation, we could show the new bone deposition on the cleft site in dental radiograph and then the prosthetic treatement to the missing teeth was done.

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Presurgical Nasoalverolar Molding in Fraternal Twins with Bilateral Cleft Lip and/or Palate: A Case Report (양측성 구순/구개열을 가진 이란성 쌍둥이를 대상으로 한 술전 비치조정형술: 증례보고)

  • Kim, Jinsun;Kim, Youngjin;Nam, Soonhyeun;Kim, Hyunjung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.72-79
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    • 2014
  • Cleft lip and palate(CLP) is one of the most common craniofacial deformities that requires systemic management involving a multidisciplinary team approach. Although there has been great improvement in the field of cleft surgery, surgical approach alone cannot resolve the various problems in treating cleft lip and palate. Hence the need for presurgical treatment was appreciated and especially, the concept of presurgical nasoalveolar molding was applied to treat unilateral and bilateral cleft lip and palate patients. Presurgical nasoalveolar molding(PNAM) of unilateral cleft mainly aims to recover nasal symmetry while the objectives of pre-surgical nasoalveolar molding in the bilateral cleft are to elongate the columella, to erect the tip of nose, and to reposition the forward displaced premaxillary region. This report covers the case of fraternal twins diagnosed with bilateral cleft. Retraction of the premaxillary region and nasoalveolar molding were conducted for 70 days until cheiloplasty, using elastic bands and nasoalveolar molding appliances. After cheiloplasty, there had been improvements in the length of columella and the position of forward-displaced premaxilla for both patients compared to their initial states. The esthetics was also satisfactory for both the surgery and the parents. In order to maximize the efficacy of the appliance, three components should be in balance; patients' adaptation to the appliance, parents' cooperation and proper selection and careful adjustment of the appliance by the dentist.

Analysis of the Expression Patterns of Thymosin β4, Vascular Endothelial Growth Factor, and Hypoxia-Inducible Factor-1α in Various Tumors Using Tissue Microarray (Tissue microarray를 이용한 여러 암에서의 thymosin β4, vascular endothelial growth factor, 및 hypoxia-inducible factor-1α 발현양상 연구)

  • Lee, Bo-Young;Lee, Seung-Hyun;Ahn, Byung-Kwon;Ock, Mee-Sun;Cha, Hee-Jae
    • Journal of Life Science
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    • v.21 no.3
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    • pp.417-423
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    • 2011
  • Thymosin ${\beta}4$ (TB-4) has been reported to play a key role in tumor growth, metastasis and angiogenesis. In addition, TB-4 induced the expression of vascular endothelial growth factor (VEGF) and stabilized the hypoxia-inducible factor (HIF)-$1{\alpha}$ in melanoma cells. Although the importance of thymosin ${\beta}4$ in angiogenesis and metastasis has been proven, there are few studies that show the expression patterns of TB-4, VEGF and HIF-$1{\alpha}$. This study was conducted to analyze the relationship among these proteins in various tumors. Using tissue microarray analysis, we investigated the expression patterns of TB-4, VEGF and HIF-$1{\alpha}$ in various tumors to identify the expression patterns and relationships of these proteins in certain tumors. TB-4 was highly expressed in osteosarcoma, colon adenocarcinoma, esophageal squamous cell carcinoma, kidney and urinary bladder transitional carcinoma, lung cancer, and liver cancer. HIF-$1{\alpha}$ was highly expressed in nasal cavity inverted papilloma, lung cancer, and esophageal squamous cell carcinoma. The expression patterns of TB-4 and HIF-$1{\alpha}$ were almost similar and co-localized. VEGF expression was high in the blood vessels in tumors, but usually not high in the tumors themselves. VEGF was moderately expressed in stomach cancer, liver angiosarcoma, gall bladder adenocarcinoma, and uterus endometrial adenocarcinoma. The expression patterns of VEGF shows similarities in certain tumors including stomach cancer, osteosarcoma, liposarcoma, lung cancer, liver cancer, gall bladder adenocarcinoma, esophageal squamous cell carcinoma, stomach cancer, colorectal carcinoma and renal cell carcinoma. These results suggest that the expression patterns of TB-4, HIF-$1{\alpha}$ and VEGF were co-localized and related to tumorigenesis and angiogenesis of certain tumors.

A study of facial soft tissue of Korean adults with normal occlusion using a three-dimensional laser scanner (3차원 레이저 스캐너를 이용한 한국 성인 정상교합자의 안면 연조직에 대한 연구)

  • Baik, Hyoung-Seon;Jeon, Jai-Min;Lee, Hwa-Jin
    • The korean journal of orthodontics
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    • v.36 no.1 s.114
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    • pp.14-29
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    • 2006
  • Developments in computer technology have made possible the 3-dimensional (3-D) evaluation of hard and soft tissues in orthodontic diagnosis, treatment planning and post-treatment results. In this study, Korean adults with normal occlusion (male 30, female 30) were scanned by a 3-D laser scanner, then 3-D facial images formed by the Rapidform 2004 program (Inus Technology Inc., Seoul, Korea.). Reference planes in the facial soft tissue 3-D images were established and a 3-D coordinate system (X axis-left/right, Y axis-superior/inferior, Z axis-anterior/posterior) was established by using the soft tissue nasion as the zero point. Twenty-nine measurement points were established on the 3-D image and 43 linear measurements, 8 angular measurements, 29 linear distance ratios were obtained. The results are as follows; there were significant differences between males and females in the nasofrontal angle $(male:\;142^{\circ},\;female:\;147^{\circ})$ and transverse nasal prominence $(male:\;112^{\circ},\;female:\;116^{\circ})$ (p<0.05). The transverse upper lip prominence was $107^{\circ}$ in males, $106^{\circ}$ in females and the transverse mandibular prominence was $76^{\circ}$ in both males and females. Li-Me' was 0.4 times the length of Go-Me'(mandibular body length) and the mouth height was also 0.4 times the width of the mouth width. The linear distance ratio from the coronal reference plane of FT, Zy, Pn, ULPm, Li, Me' was -1/-1/1/0.5/0.5/-0.6 respectively. The 3-D facial model of Korean adults with normal occlusion were be constructed using coordinate values and linear measurement values. These data may be used as a reference in 3-D diagnosis and treatment planning for malocclusion and dentofacial deformity patients and applied for 3-D analysis of facial soft tissue changes before and after orthodontic treatment and orthognathic surgery.

Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

A Clinical Study on Allergic rhinitis (알레르기 鼻炎의 臨床的 硏究)

  • Cho Soo-hyun;Jee Seon-young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.173-182
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    • 2001
  • This Study is attempted in order to observe a clinical analysis from Constitution medical view point about allergic rhinitis. We studied 71 patients who had visited Dept. surgery, opthalmology & otolaryngology, col1ege of Oriental Medicine, Kyungsan University, Pohang, Korea and were treated by medications of Sasang Constitution and Constitution-Acupunture with allergic rhinitis from March 1, 2000 to February 28, 2001. The results were as follows: 1. The sex distribution was 71 males($69\%$), 22 femail($31\%$), In age distribution, the average was 29.6. The peak age was thirties($36.7\%$), teen-ager was $23.9\%,\;fortieth\;was\;15.5\%,\;under\;10\;years\;old\;was\;9.9\%,\;twenties\;was\;7\%,\;fifties\;was\;5.6\%,\;sixtisth\;was\;1.41\%$. 2. In the age of onset, thirties was $29.6\%$, teen-ager was $19.7\%$, twenties was $18.3\%$, under 10 years old and fortieth was $14.1\%$, fifties was $3.8\%$, sixtisth was $1.41\%$. 3 In monthly distribution. september was $25.8\%$, january was $14.1\%$, october was $11.3\%$. november and august was $8.5\%$, april was $7\%$, febuary and may were $5.6\%$, june, july. December were each $4.2\%$, In the distribution of season. the peak season was fall from september to November. 4. In the duration of the disease, 1-3 years was $26.8\%$, 3-5 years was $19.7\%$, 6 months - 1 year $16.9\%$, 5-10 years was $14.1\%$, under 6 months was $11.3\%$, over 10years and over 15 years were each $5.6\%$. 5. In the three main symptom, hydrorrhoea was $71.8\%$, nasal obstruction was $67.6\%$, sneezing was $64.8\%$. In others, fatique was $25.6\%$, headache was $14.1\%$, itching and cough was $11.3\%$, laryngopharyngeal discomfort and red eye were $4.2\%,\;infirmity\;was\;2.8\%$. 6. Patients whose families have allergic disease account for 26 cases($36.6\%$). 7. There was no past history in 37 cases($52.l\%$). In past history distribution, digestive tract disease was $12.7\%$, paranasal sinusitis was $8.5\%$, allergic dermatitis was $7\%$, common cold was $4.2\%$. otitis media, bronchitis, asthma, tonsillitis were $2.8\%$. 8. Sasang Constitution classification was Soyanggin in 52 cases($73.2\%$), Taeumgin in 12 cases($16.9\%$). Soumgin in 7 cases($9.9\%$). 9. In the duration of treatment, it was 1-2 weeks in 26 cases($36.6\%$), 2-4 weeks was $21.1\%$, under 1weeks was $14.1\%$, 4-6 weeks was $11.3\%$, 6-8 weeks was $8.5\%$, 8-10 weeks was $5.6\%$, over 10 weeks was $2.8\%$. 10. We had a follow-up survey the effect of treatment in the 60 cases. there was fair in 25 cases($41.7\%$), good in 21cases($35\%$), excellent in 3cases($5\%$)로 total rate of treatment was $81.7\%$. The case of no change was $16.7\%$, the case of poor was $1.6\%$.

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The Study on the Trends of Resecarch Papers Published in the Journal of Oriental Medical Surgery?phthalmology & Otolaryngology Society. (大韓眼耳鼻咽喉皮膚科學會誌에 揭載된 硏究論文들의 傾向性 考察)

  • Kwon, Kang;Seo, Hyung-sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.16 no.1
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    • pp.1-32
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    • 2003
  • Objectives: This study was carried out to analyze and understand the trends of research papers published In the Journal of Oriental Medical Surgery?phthalmology & Otolaryngology Society(JOMSOOS). Methods: We studied the 308 research papers that had been published in JOMSOOS from 1988 Vol. 1. No. 1. to 2002 Vol. 15. No. 2. Our study was developed through the four stages in order to analyze the papers; 1) we analyzed all the papers overall to classify them into three categories; original article. review article and case report. 2) we classified the original articles in terms of methodology. 3) we also analyzed the case reports according to the sort of disease each paper dealt with. 4) we had another statistical approach to each paper to figure out the distribution of diagnoses in detail. Results: We have got the following outcomes from our analysis of the papers in terms of the four stages. 1. Overall Analysis. 1) Classification of 308 research papers between 1988 and 2002: 137 original articles(44.48$\%$), 111 review articles(36.04$\%$), 56 case reports(18.18$\%$). 2) Used language: Korean(99.03$\%$). English(0.97$\%$). 3) The Number of Authors: 2 persons(42.86$\%$). 3 persons(29.87$\%$), 1 person(14.61$\%$). 2. Original Article Analysis 1) Classification of 137 original articles in terms of methodology: 90 experimental studies(65.69$\%$)46 descriptive studies(33.58$\%$), 1 analytic study(0.73$\%$). 2) Classification of the original articles according to the use of statistical methods: No statistical methods(36.42$\%$), Descriptive methods only(1.99$\%$), Not defined(23.18$\%$), t-test(24.50$\%$), ANOVA(3.97$\%$), Multiple comparison(2.65$\%$), Non-parametric test(2.65$\%$), Other methods(1.32$\%$). 3) Classification of 46 descriptive articles in terms of diseases: otorhinolaryngology(43.48$\%$), dermatology(23.91$\%$), ophthalmology(13.04$\%$), facial palsy(13.04$\%$). 4) Classification of descriptive articles in terms of the number of patients: the highest was 'more than 26 but less than 50 persons'(19 articles - 41.30$\%$). 5) Classification of descriptive articles in terms of the period for patients observation: the highest was the time 'more than 9 but less than 12 months(34.78$\%$)' Out of the 34.78$\%$, the number of articles with the patients observed for more than 12 months was 13(28.26$\%$). 3. Case Report Analysis 1) Classification of 56 case reports in terms of the sort of disease: dermatology(44.64$\%$), ophthalmology(19.64$\%$), otorhinolaryngology(14.29$\%$), facial palsy(8.93$\%$). 2) Classification in terms of the number of patients: 1 person(50$\%$), 3 persons(16.07$\%$), 2 persons(14.29$\%$). 4. Diagnosis Distribution of Each Disease. 1) Studies regarding ophthalmology : the percentage of 'strabismus' cases was the highest(33.33$\%$). 2) Studies regarding otorhinolaryngology : nasal inflammation(34.48$\%$), tinnitus(20.69$\%$). 3) Studies regarding dermatology: the percentage of 'allergic skin disease' was the highest(33.33$\%$). Conclusions: We analyzed the trends of research papers that have been published in JOMSOOS in detail. We came to understand the trends of the research through this study. However, we acknowledge that we only adopted the quantitative method out of various possible analysis methods. For further studies, we strongly urge to adopt the qualitative methods as well.

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THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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Snoring Clinic Visitors' Knowledge of Obstructive Sleep Apnea Syndrome (코골이 클리닉을 방문한 환자들의 폐쇄성 수면무호흡증 인식도)

  • Lee, So-Jin;Lee, Jin-Seong;Shin, Hong-Beum;Cho, Sang-Yong;Rhee, Chae-Seo;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.87-94
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    • 2011
  • Objective: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. Method: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. Results: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. Conclusion: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.

Supplemental Value of the Wrist-Worn Actigraphy in Diagnosing the Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 진단에서 손목부착형 활동기록기의 보조적 진단가치)

  • Im, Mee-Hyang;Shin, Hong-Beom;Lee, Yu-Jin;Lee, Seung-Hi;Won, Chang-Yeon;Lee, Myung-Hee;Lee, Soo-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.32-38
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    • 2005
  • Objectives: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. Methods: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male:female 20: 7;age $47.6{\pm}12.9$ years old;age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. Results: Mean total sleep time on polysomnography was $401.4{\pm}57.8\;min$ (range of 274.0 to 514.1 min). Mean RDI was $21.7{\pm}20.4/hour$. Mean FI was $21.9{\pm}13.0/hour$. RDI and FI showed significant correlation (r=0.55, p<0.01). Conclusions: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.

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